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Healthcare Economist Uwe Reinhardt Has Died

"Uwe Ernst Reinhardt (September 24, 1937 - November 14, 2017) was a professor of political economy at Princeton University and held several positions in the healthcare industry. Reinhardt was a prominent scholar in health care economics.... Reinhardt's research focused on hospital pricing, systems of health care around the world, Medicare reform, and health care spending." [BenefitsLink has been pleased to link our readers to articles about Reinhardt's research since 2003.]

The Pitfalls of Cost Sharing in Healthcare

"[B]ecause the benefits of health care treatment are often long-term, can be difficult to observe, and often come with side effects, the costs and benefits that a patient observes may not be the same as the actual cost of production and cost sharing may discourage the use of cost-effective, high-value medical or pharmaceutical interventions. [This short video] provides [an] overview summary of the potential benefits and key pitfalls of cost sharing."

Nobel Prize-Winning Economist Joseph Stiglitz on Single Payer

Excerpt: Joseph Stiglitz: I think that there are some fundamental problems in the efficiency of our healthcare system. And what we've seen is that the private healthcare insurers do not know how to deliver an efficient way. Amy Goodman: Do you support single-payer healthcare? Joseph Stiglitz: I think I've reluctantly come to the view that it's the only alternative. You know, we've tried a lot of other things. And we've been -- you know, I was in the Clinton administration, and we debated a lot of alternatives, and I've watched things as they've emerged and, you know, evolved over the last twelve, sixteen years, and I think there's a growing consensus that the private market exclusion is not going to work.

Uwe Reinhardt: 'The U.S. is Not a Democracy; it's an Aristocracy' - Implications for Healthcare Reform

Excerpt: In a private conversation with bloggers at the Families USA healthcare conference last week, Princeton healthcare economist Uwe Reinhardt recalled a conversation, when he asked health care economist Victor Fuchs, 'When will we ever have universal health insurance in the U.S.?' Fuchs' answer: 'Not until World War III, a Great Depression, or a major epidemic that threatens everyone.'

Most Favored Nation Drug Pricing in the U.S.: Comparing GENEROUS, GLOBE and GUARD

"The Trump administration has introduced three most-favored-nation (MFN) drug pricing initiatives designed to link U.S. pharmaceutical costs to prices paid in economically comparable countries. Most-favored-nation pricing requires manufacturers to provide rebates when U.S. prices exceed those in reference nations—a direct response to the persistent gap between U.S. drug prices and those in other developed economies. [This article summaries three programs that] have been implemented: [1] GENEROUS (GENErating cost Reductions fOr U.S. Medicaid) Model; [2] GLOBE (Global Benchmark for Efficient Drug Pricing) Model; [3] GUARD (Guarding U.S. Medicare Against Rising Drug Costs) Model."

How Will AI Change Health Care in 2025?

"To answer this question, [the author] asked different AIs what the answer would be."

Does PBM Market Share Vary by Payer Type?

"A [recent paper] quantifies the degree of of pharmacy benefit manager (PBM) market concentration.... Three PBMs dominate in most all markets. In fact, these three large PBMs (CVS Caremark, Optum Rx, and Express Scripts) account for 73.6% of retail prescriptions filled. This does vary by payer type. "

Medicare Drug Price Negotiation Leads to 38% to 79% Price Decrease

"The maximum fair prices (MFP) set by Medicare lead to discounts between 38% and 79%. In fact, the real discounts are larger since the figures ... are discounts off of 2023 prices (rather than 2024 prices).... [H]ow exactly did CMS arrive at these prices? This is not clear. In fact, CMS said it won't make public an explanation of the agreed-upon negotiated prices until March 2025."

Recent Medicare Attempts to Lower Drug Prices (Beyond IRA)

"[T]he Centers for Medicare and Medicaid Innovation (CMMI) has proposed a number of a number of payment models intending to address pharmaceutical cost, spending, and reimbursement.... Most recently, ... CMMI proposed 3 new models related to drug prices: [1] Medicare High-Value Drug List, [2] Cell and Gene Therapy (CGT) Access model, and [3] Accelerating Clinical Evidence model.... Prior to the development of these models, CMMI also proposed 9 other drug pricing models.... The impact of the implemented programs was mixed."

CMS Guidance on Prescription Drug Price Negotiation, Part 2

"What mandatory data are manufacturers required to submit?  ... What data are manufacturers optionally allowed to submit?  ... Is CMS allowed to consider cost effectiveness studies? ... Can you provide more detail on the specific data elements manufacturers need to submit?"